Since the inception of adult education as a professional field of practice in the early twentieth century, educators have produced several orientations, theories, and philosophies on adult learning, and have wondered how best to apply these in their teaching environments. While theories may be universally recognized, one's own orientations and philosophy is what drives an educator's teaching habits and how they regard their learners. Educators must ask themselves a series of questions to root this out: What is the purpose of education? What is my role as an educator versus the role of the student? How does my viewpoint affect my philosophy? (Tisdell and Taylor, 2002) Though impossible to determine the "correct" philosophy that all educators should subscribe to, an attempt is made to establish yet another argument for how best to learn and teach, both personally and in the professional context of medical education.
The basis of any adult education philosophy is generally formed from one, or a combination, of five orientations: liberalism, progressivism, behaviorism, humanism, and radicalism. The preceptor must decide which of these supports their basic perspective of what happens when learning occurs. It is my opinion that, while it can be social and context bound, learning is a mental process that occurs when creating meaning from experiences which develop the whole person - resulting in changes in behavior. Zinn's (1990) self-administered philosophy of adult education inventory was completed and revealed that the philosophies of liberal adult education and behaviorist adult education most aligned with my personal beliefs. The amalgamation of these concepts directs my idea of what the purpose of education is - to make a person knowledgeable and cultured in the broadest sense and to precipitate behavior that will safeguard the survival of the individual and mankind as a whole. I presume that people are always learners and that the student seeks knowledge rather than simply information by taking an active role in learning.
Similar to the orientations, or "traditional" learning theories, there exists a number of central theories to explain adult learning; namely, andragogy, self-directed learning, transformative learning, and experiential learning. Andragogy was made popular when it was adopted by Malcolm Knowles in the 1980s as the method and practice of teaching adult learners. Within this framework, Knowles developed six assumptions that adult learners: (1) are independent or self-directed, (2) possess a growing pool of experience, (3) have learning needs tied to their social role, (4) are problem-centered, (5) are driven to learn by internal motivation, and (6) need to know why they are learning something (Merriam and Bierema, 2014). While these assumptions were logical, even prior to being educated on learning as a competitive advantage, there was a question of inclusivity to just adult learners. That is to say, in some cases adults can be just as dependent as children; and some children can have had much more meaningful experiences than some adults from which to learn from, for example. After reconsideration, Knowles himself realized this later on and concluded that andragogy is less an adult learning theory than "a model of assumptions about learning or a conceptual framework that serves as a basis for an emergent theory" (1989, p. 112). Thus, I reject andragogy as an adult learning theory but accept it as the foundation from which other theories emerge.
The term "self-directed learning" can be used to describe both a personal characteristic and a process. As a trait, it represents self-efficacy, initiative, independence, self-discipline, and a strong sense of curiosity. In applying these attributes to education, self-directed learning becomes a process. Within my philosophical system, self-directed learning is integrated into a collaborative classroom environment with traditional formative and summative tasks. Thus, learners can rely on the constitution of traditional learning while still "tak[ing] the initiative, with or without the help of others, in diagnosing their learning needs, formulating learning goals, identifying human and material resources for learning, choosing and implementing appropriate learning strategies, and evaluating those learning outcomes" (Knowles, 1975, p. 18).
Transformative learning is a favored and well-researched adult learning theory in which a person's perspective is fundamentally changed by what they learn. It is a process "by which we transform our taken-for-granted frames of reference...to make them more inclusive, discriminating, open, emotionally capable of change, and reflective..." (Mezirow and Associates, 2000, p. 8). Mezirow believed that transformative learning occurred in cyclical manner in which the learner experiences a disorienting dilemma, performs a self-examination, explores their options via a critical assessment, plans a course of action, tries out new roles, and reintegrates their learning into their life. Though several plans exist to rationalize the process of transformation in learning, it is some of Cranton and Hoggan's evaluation methods (2012) used to determine if a transformation has taken place that I would integrate into my philosophy: conceptual mapping, interviews, metaphor analysis, observations, narratives, surveys, self-evaluations, checklists, and journals.
The theory of experiential learning posits that learners make meaning of their experiences. Kolb developed the most well-known model for this in 1984:
Learners, if they are to be effective, need four different kinds of abilities - concrete experience abilities (CE), reflective observation abilities (RO), abstract conceptualizing abilities (AC), and active experimentation abilities (AE). That is, they must be able to involve themselves fully, openly and without bias in new experiences (CE). They must be able to reflect on and observe their experiences from many perspectives (RO). They must be able to create concepts that integrate their observations into logically sound theories (AC) and they must be able to use these theories to make decisions and solve problems (AE) (p. 30).
Kolb further believed that learners have four basic learning styles that rely on these learning abilities: diverging (CE and RO), assimilating (RO and AC), converging (AC and AE), and accommodating (AE and CE). The Learning Style Inventory (LSI) was generated to assess a learner's preference for learning using this model. While I believe that learning is a bit more complex than this model suggests, the LSI is a meaningful tool to get a basic sense of how a student learns and could be used as a starting point to formulating a learning plan.
Another experiential learning model was developed in 1987 by Peter Jarvis and accounts for nine types of learning as compared to Kolb's overly simplistic model. These are subcategorized into non-learning, non-reflective learning, and reflective learning types. The first of these involves taking things for granted, or presumption, non-consideration, and rejection. The second includes incidental non-reflective learning, which is further broken down into learning about self through non-consideration and rejection, preconscious knowledge learning, preconscious skills learning, and conscious non-reflective learning (basic skills learning and memorization). Finally, reflective learning encompasses cognitive learning, practice learning, and contemplation as a result of both social and private experiences. Depending on which type of learning a student engages in, they go through the following ten stages in different orders, and may even skip some of them: (1) person/biography/experience, (2) social situation, (3) an episodic experience, (4) person unchanged, (5) practice, (6) experiment, (7) memorize, (8) thought/reflection, (9) evaluation, and (10) person - more developed and experienced (Bergsteiner and Avery, 2009). While Jarvis' existential learning model undoubtedly accounts for a number of ways adult learning can take place, it carries added confusion with it as well. As such, I would likely incorporate this in my philosophy when dealing with an extremely diverse set of learners that cannon be basically categorized by Kolb's cycle.
Additionally, students in medical and surgical education must, by nature of their professions, actively continue to learn throughout their careers. Medical school and subsequent training programs naturally provide some structure to their education, bu the majority of their learning throughout their lives is expected to be self-directed. Towle and Cottrell (1996) succinctly explain strategies and methods that my philosophy adopts to support this objective and ensure the attainment of learning goals:
Clear, advance information about tasks
Specific performance goals for assignments
Intrinsic rewards for task completion
Timetabling that allows sufficient time for task completion
Trust that learners will remain on task
Support for student learning, for example, personal tutors, study skills courses
Formative assessment and feedback that enables students to monitor and modify their own learning
Appropriate summative assessment, that is, that tests problem solving rather than rote repetition of facts
Appropriate staff development/teacher training (p. 358)
Bergsteiner, H., & Avery, G. C. (2009). Jarvis’ existential learning model: Making it work. Journal of College Teaching & Learning, 6(1), 51-60. doi: 10.19030/tlc.v6i1.1181
Cranton, P., & Hoggan, C. (2012). Evaluating transformative learning. In E.W. Taylor & P. Cranton (Eds.), The handbook of transformative learning (p. 520-535). San Francisco: Jossey-Bass.
Jarvis, P. (1987). Adult education in the social context. London: Croom Helm.
Knowles, M. S. (1975). Self-directed learning: A guide for learners and teachers. New York: Association Free Press.
Knowles, M. S. (1989). The making of an adult educator. San Francisco: Jossey-Bass.
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs: Prentice Hall.
Merriam, S. B., & Bierema, L. L. (2014). Adult learning: Linking theory and practice. San Francisco: Jossey-Bass.
Mezirow, J., & Associates. (2000). Learning as transformation: Critical perspectives on a theory in progress. San Francisco: Jossey-Bass.
Tisdell, E. J., & Taylor, E. W. (2000). Adult education philosophy informs practice. Adult Learning, 11(2), 6-10. doi: 10.1177/104515959901100203
Towle, A., & Cottrell, D. (1996). Self directed learning. Archives of Disease in Childhood, 74(4), 357-9. doi: 10.1136/adc.74.4.357
Zinn, L. M. (1990). Identifying your philosophical orientation. In M. W. Galbraith (Ed.), Adult learning methods (p. 39-56). Malabar: Krieger Publishing Company.